S T R E E T R O O T S P H O T O l U L L Ä T R A T IO N
Traumatic brain injuries often go undiagnosed, especially on the streets
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B Y K A T E t< S X
C O N T R IB U T IN G
W R IT E R
■w T ou might say Nick Patton was born to fish.
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Literally born on a boat, Nick spent his .
earliest years living in orphanages along the
Alaskan coastline. He ran away at the age. of eight
and quickly learned how to take careof himself and
to rely on others - traveling in groups around the
Pacific Northwest, picking apples and doing day
labor.
He was only 11 years old when he started
working the boats and canneries of the Alaskan
fishing industry. With a community of other
fisherman, Nick followed the seasonal work, living
on boats and in tents, even during the cold
Anchorage winters. .
It all ended with the smack of a crowbar.
Nick was 32 and alone on the night he was
attacked, and there were no witnesses. With no
memory of the assault, he has few clues to the
story except for the scar on his forehead where the
crowbar cracked his skull.
“First it hurt the front of my brain, because
that’s where they hit me. Then, the force caused
my brain to hit the back of my skull, back here.
Then, there was also some swelling, so that caused
more damage - way down here in my brain stem.
Nick woke up in an Anchorage hospital, but
nothing was ever the same. His gregarious nature
was now drowned out by voices and hallucinations,
and reality was lost in the din.
“I couldn’t deal with society anymore. I didn’t
know what was real or who to trust. I ended up
cutting all ties to the world.”
Alcohol and drugs became his only way of
coping. “If I stayed high I could deal with it.” For
the first time in his life, Nick found himself unable
t o w o r k a n d s p e n t t h e n e x t s e v e r a l y e a r s s e ll in g
h e ro in , p an h an d lin g , an d living o n th e s tr e e ts .
Unfortunately, Nick’s story isn’t unique.
News about traumatic brain injury, or TBI, has
increasingly come to light in recent months, from a
spate of sports-related injuries particularly among
football players, to the blast injuries of veterans
r e tu r n in g fro m Afghanistan and Iraq. Although,
homelessness can be the ultimate tragic
consequence of a brain injury, the medical world is
only beginning to connect the dots between TBI
and homelessness.
According to the National Healthcare for the
Homeless Council, at least half of all homeless
individuals have experienced at least one head
injury in their lifetime.
“Brain injury in the homeless community is a
very common thing that we’re just starting to learn
about,” says Dr. Barb Wismer, a practicing
physician who serves on the board of the Council.
Few formal studies have been done, but those few
are sobering.
In one recent study of 904 homeless men and
women in Toronto, Ontario, 53 percent reported
some type of traumatic brain injury. Studies in
Milwaukie, Wisconsin and Boston, Massachusetts
offer similar statistics of 48 and 67 percent
The Toronto study found that for those who had
experienced a head injury, 70 percent had suffered
the injury prior to becoming homeless. And
although there is no clear cause and effect the
results suggest that TBI could be at least one
contributor to some individuals’ homelessness.
That shouldn’t be so surprising, as the long-term
effects o f a brain injury can be debilitating,
Symptoms vary widely. Some are as dramatic as
Nick’s hallucinations. Others are much more
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th e revolution
s u b t le . S o m e t i m e s d e s c r i b e d a s a n “in v is ib l e
disab ility ,” b ra in in ju ry o fte n c a u s e s p ro b le m s w ith
m em o ry , c o n c e n tra tio n an d th in k in g , as w ell a s th e
ability to regulate emotion and behavior.
As a result, brain injury survivors often have a
hard time doing the work they did before their
injuries. Family and social relationships suffer,
s tr ain in g the most immediate safety net before
homelessness.
"Brain Injury In the homeless
community is a very common
thing that we're just starting to
learn about."
— DR. BARB W IS M E R
N A T IO N A L H E A L T H C A R E
FO R T H E H O M E L E S S C O U N C IL
The same symptoms can also create barriers for
those individuals once they are on the streets. .
Navigating shelter systems, attending to basic
health and hygiene, and accessing services can be
overwhelming and difficult. Controlling anger can
be a daily struggle.
And once on the streets, the risk qf brain injury
continues. Steve Hill suffered head injuries
throughout his adolescence and adulthood, from
sports injuries to snow boarding to fight clubs. He
describes each one As taking him down another
notch. Even small injuries caused intense
reactions including vomiting and confusion. “You’re
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